• Journal of Pharmacopuncture
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• v.25 no.2
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• pp.71-78
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• 2022

Objectives: Post-term pregnancy is a condition associated with increased maternal and fetal complications. Administration of castor oil causes cervical stimulation by increasing the production of prostaglandins. We examined the effects of castor oil on cervical ripening and labor induction through a systematic review and meta-analysis. Methods: The search process was performed to obtain relevant articles from databases including Pubmed, Cochrane library, Scopus, Science direct, SID, Iran Medex, and Google Scholar using the English keywords of cervical ripening, post-term, castor oil, labor induction, Bishop score, and pregnancy considering all possible combinations without time constraints and their Persian equivalents from national databases. Results: A total of eight related articles from the 19 primary studies were extracted and systematically reviewed. According to a cumulative chart, the difference in the post-intervention Bishop score was statistically significant (standard mean difference [SMD]: 1.64, 95% confidence interval [CI]: 1.67-2.11, p = 0.001), indicating an effect of castor oil on increasing the Bishop score. In addition, the difference in labor induction was statistically significant after the intervention (odds ratio: 11.67, 95% CI: 3.34-40.81, p = 0.001), indicating an effect of castor oil on increasing the odds ratio of labor induction (experience of vaginal delivery). Conclusion: This meta-analysis showed that oral administration of castor oil is effective for cervical ripening and labor induction. Midwives should closely monitor pregnant women with prolonged labor and collaborate with obstetricians to employ castor oil as a safe intervention to induce cervical ripening and labor to prevent undue caesarean surgery.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.29-35
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• 2022

Objectives The purpose of this systematic review is to analyse randomized controlled trials about acupuncture for patellofemoral pain syndrome (PFPS) and evaluate it's pain improvement effect. Methods Studies will be searched from ten databases (Medline/PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure [CNKI], WanFang Data, Citation Information by NII [CiNII], ScienceON, Koreanstudies Information Service System [KISS], KMBASE, and KoreaMed). Participants will be patients diagnosed with PFPS, regardless of cause, gender, age or race, and interventions will be acupuncture, electroacupuncture, dry needling, fire needle, and acupotomy. Other treatments than interventions will be the control group and the main outcome will be reviewed by visual analogue scale (VAS). Results Data will be extracted and assessed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis flow chart and Cochrane risk of bias tools. Meta-analysis will be conducted using random effect model within 95% confidence interval. Conclusions We expect this systematic review to provide useful data about the pain improvements of patellofemoral pain using acupuncture and expect to stimulate and systematize acupuncture treatment on PFPS in the future.

• Imaging Science in Dentistry
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• v.34 no.1
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• pp.25-30
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• 2004

Purpose: Several panoramic indices have been suggested to assess bone quality from the morphology and width of mandibular cortex on panoramic radiography. The purpose of this study was to compare dental implant failure group with control group in panoramic mandibular index (PMI), mandibular cortical index (MCI), and gonion index (GI) and to determine the effect of these panoramic indices on dental implant failure. Materials and Methods: A case-control study was designed. Test group (n=42) consisted of the patients who had their implants extracted because of peri-implantitis. Control group (n=139) consisted of the patients who retained their implants over one year without any pathologic changes and had been followed up periodically. They had dental implants installed in their mandibles without bone augmentation surgery from 1991 to 2001. The following measures were collected for each patients: 1) PMI, MCI, and GI were measured twice at one-week interval on preoperative panoramic views; and 2) age, sex, implant length, implant type, installed location, occluding dentition state, and complication were investigated from the chart record. Results: The PMI showed moderate level of repeatability. The intra-observer agreement of MCI and GI were good. There was statistically significant difference in PMI between two groups. There were significant different patterns of distribution of MCI and GI between two groups. Among the panoramic indices, PMI and MCI showed significant correlation with dental implant failure. Conclusion: Panoramic indices can be used as reference data in estimating bone quality of edentulous patients who are to have implants installed in their mandibles.

• Journal of Acupuncture Research
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• v.27 no.4
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• pp.239-245
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• 2010

Objectives : The aim of this study is to evaluate the effect of cervical Hyeopcheok(Jiaji) point for neck pain. Methods : The twenty-nine patients who feel neck pain, are chosen from chart review, received acupuncture treatment on cervical Hyeopcheok(Jiaji) point. The evaulation of progress was checked by NDI(neck disability index), and VAS(visual analog scale). Data were analyzed by Friedman two way analysis of variance and Wilcoxon matched pairs signed rank test. Results : NDI value(mean${\pm}$SD) was $17.76{\pm}8.26$(n=29) at the first visit, $13.41{\pm}8.04$(n=29) at 3days after treatment, $10.85{\pm}8.46$(n=26) at 5days, $11.00{\pm}7.80$(n=13) at 9days, $7.22{\pm}4.76$(n=9) at 15days, $3.86{\pm}4.06$(n=7) at 20days, and $3.33{\pm}3.78$(n=6) at 30days. VAS value(mean${\pm}$SD) was $4.07{\pm}1.33$(n=29) at the first visit, $12.97{\pm}1.05$(n=29) at 3days after treatment, $2.15{\pm}1.12$(n=26) at 5days, $2.15{\pm}0.99$(n=13) at 9days, $1.56{\pm}0.73$(n=9) at 15days, $1.29{\pm}0.49$(n=7) at 20days, and $0.83{\pm}0.41$(n=6) at 30days. The value of NDI and VAS gradually decreased. Repeated measurement results(the difference between the first visit and each measurement day) and the difference between before and after the interval(except between 5 and 9days, between 20 and 25days) were statistically significant. Conclusions : This result was shown that treatment of cervical Hyeopcheok(Jiaji) acupuncture point for neck pain can be effective. Further systematic research will be needed.

• Child Health Nursing Research
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• v.20 no.3
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• pp.215-224
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• 2014

Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.526-537
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• 1999

Objectives : It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. Methods : Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years' follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. Results : In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of $\geq$ 110 mg/dl compared with $\leq$ 80 mg/dl, Hazard Ratio[HR]:15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI $\geq$ 25.3 compared with $\leq$ 21.3) was 7.19(95% CI=3,75-13.8); of weight change during middle life(>10kg compared with $\leq$ 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper fertile compared with lower fertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). Conclusion : The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.

• Advances in pediatric surgery
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• v.10 no.1
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• pp.1-8
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• 2004

A re-pull-through operation for Hirschsprung's disease is performed when the primary operation has failed because of the remnant or acquired aganglionosis, anastomotic stricture and/or fistula. The purpose of this study is to review our experience of the re-pull-through procedure for Hirschsprung's disease. From May 1978 to July 2003, 26 patients who underwent re-pull-through operations at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were studied retrospectively by means of chart review as well as telephone interview. The mean age at primary operation and re-operation were llmonths (2 months - 10 years) and 43 months (1 year - 23 years 3 months), respectively. Initial operation for Hirschsprung's disease was Duhamel's procedure in 17, Swenson's in 6 and Soave's 3. Causes of failure of primary operation were remains of secondary aganglionic segment (n=23), vascular arcade injury (n= 1), rectoperineal fistula (n=2, due to mesenteric torsion and poor blood supply), Mean interval between the primary operation and the re-operation was 34 months (6 months-22 years). Reoperation methods were Soave's in 12, Duhamel's in 8, APSP (abdomino-posterosagittal pull-through procedure) in 5, and Swenson's in 1 case. In 2 cases of repeated rectoperineal fistula or rectourethral fistula, re-APSP were performed 3 times, respectively. A total of 29 re-pull-through operations were performed. Postoperative complications were wound infection (n=1), adhesive ileus (n=1), rectoperineal fistula (n=3), rectourethral fistula (n=2), and death due to pulmonary embolism (n=1). Mean follow up period of reoperation was 78 months (1 month-23years). In current state, 2 patients have an ileostomy because of repeated rectoperineal fistula and rectourethral fistula. Of the remaining 23 patients, 21(91 %) are totally continent with or without minimal soiling. Reoperation for Hirschsprung's disease was effective and safe for the patients complicated to the initial pull-through operation.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.350-362
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• 2018

Objectives: By analyzing the characteristics and the distribution of diseases of patients who visited the emergency room of a Korean medical hospital, we sought to determine the methods of activating the Korean emergency medical system and to use this analysis as a basis for future research. Methods: We conducted a retrospective review of 959 patients who visited the emergency department of the Dong-Eui University Korean Medical Hospital from January 2016 to December 2016. The review was conducted using electronic medical records created during the emergency department visit. Results & Conclusions: In distribution of sex, the rate of males was 47.9%, and that of females was 52.1%. In distribution of age, the greatest number of patients were in their 50s (27.5%), followed by those in their 60s (19.9%) and 40s (14.8%). In distribution of residence, most patients were from Busan (84.9%). In distribution of week, more patients visited the emergency room on Sundays and holidays (44.3%). September was the busiest month (12.5%). Visits usually occurred during daytime and nighttime, and there were few visits at dawn. In the analysis of the time interval between onset of symptoms and the emergency room visit, most patients visited within 24 hours (46.5%). In the distribution of diseases, facial palsy was the most common (34.6%). In the systematic distribution of diseases, circulatory diseases were the most common (56.7%), followed by diseases of the musculoskeletal system (28.6%). The rate of first emergency room visit was 52.9%, and the rate of revisit was 47.1%. The rate of hospitalization after emergency room treatment was 27.5%, and the rate of discharge was 72.4%. The rate of revisit was 63.4%. In the distribution of treatment before arrival at the emergency room, direct was the most common (51.0%), and the outpatient department of western medicine was next. In the distribution of treatment in the emergency room, acupuncture was the highest (91.4%), followed by herb-med (43.0%).

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.723-729
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• 2017

Objective : Acute subdural hematoma (ASDH) is generally considered a condition that should be managed surgically. However, some patients initially receive conservative treatment, a subset of whom require surgical intervention later. This study aimed to evaluate the predictors of delayed surgical intervention in ASDH patients who are initially managed conservatively. Methods : From January 2007 to December 2015, 842 patients diagnosed with ASDH were treated at our institution. Among them, 158 patients with convexity ASDH were initially treated conservatively. Patients were divided into a delayed surgery group and a conservative group. Demographic characteristics, past medication and medical histories, and radiological and laboratory data were collected by retrospective chart review. Independent risk factors were identified with univariate and multivariate analyses. Results : Twenty-eight patients (17.7%) underwent delayed surgical intervention. Their mean age was 69.0 years, and 82.1% were male. Hypertension, diabetes mellitus, and heart disease prevalence and use of anti-platelet agents did not significantly differ from the conservative group. However, age (p=0.024), previous cerebral infarction history (p=0.026), increased maximal hematoma thickness (p<0.001), midline shifting (p=0.001) and accompanying subarachnoid hemorrhage (p=0.022) on initial brain computed tomography (CT) scan, low hemoglobin level (p<0.001), high leukocyte count (p=0.004), and low glucose level (p=0.002) were significantly associated with delayed surgical intervention. In multivariate analysis, increased maximal hematoma thickness (odds ratio [OR]=1.279, 95% confidence interval [CI] 1.075-1.521; p=0.006), low hemoglobin level (OR=0.673, 95% CI 0.467-0.970; p=0.034), and high leukocyte count (OR=1.142, 95% CI 1.024-1.272; p=0.017) were independent risk factors for delayed surgical intervention. Conclusion : Due to the high likelihood of delayed surgical intervention among minimal ASDH patients with a thicker hematoma on initial brain CT, lower hemoglobin level, and higher leukocyte count, these patients should receive more careful observation.

• Archives of Craniofacial Surgery
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• v.21 no.4
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• pp.229-236
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• 2020

Background: Oncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. Methods: A retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. Results: A total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio [OR], 2.85; 95% confidence interval [CI], 1.1-7.3; p=0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p=0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p=0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p=0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p=0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p=0.022) were risk factors for mortality. Conclusion: Both preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.